Page 968

West Virginia Income Maintenance Manual Chapter 9

West Virginia Income Maintenance Manual Page 24 Chapter 9 Client Notification

9.4 COMPUTATION FORMS The Department of Human Services (DOHS) is required to provide the client with the calculations used to determine eligibility and benefit level. The following forms must be used. If a computation form is not available, the Worker must prepare a letter explaining the computation. When manually-prepared, the original is sent with the notification letter, and a copy is retained in the case record. Each of the following forms is self-explanatory. They guide the Worker through the various steps of the income calculations. 9.4.1 DFA-NL-SNAP-1, SNAP COMPUTATIONS This form must be sent with each DFA-NL-A sent for approval of SNAP benefits and to each applicant denied for income reasons. In addition, it must be sent with each DFA-NL-C and each DFA-NL-B sent for notification of an increase, decrease, or closure of SNAP benefits, when recalculations of income eligibility or benefit level are required. 9.4.2 DFA-WVW-1, WV WORKS COMPUTATIONS This form must be sent with each DFA-NL-A sent to the client for approval of WV WORKS benefits and to each applicant denied for income reasons. In addition, it must be sent with each DFA-NL-A and DFA-NL-C sent for notification of ineligibility due to income reasons. 9.4.3 DFA-NL-MN-1, AFDC-RELATED MEDICAID COMPUTATIONS This form must be sent with each DFA-NL-A sent for approval of AFDC-related Medicaid benefits. In addition, it must be sent with each DFA-NL-C and DFA-NL-B sent for changes in the spenddown amount.

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Page 968

Official source

West Virginia Income Maintenance Manual Chapter 9

West Virginia Income Maintenance Manual Page 24 Chapter 9 Client Notification

9.4 COMPUTATION FORMS The Department of Human Services (DOHS) is required to provide the client with the calculations used to determine eligibility and benefit level. The following forms must be used. If a computation form is not available, the Worker must prepare a letter explaining the computation. When manually-prepared, the original is sent with the notification letter, and a copy is retained in the case record. Each of the following forms is self-explanatory. They guide the Worker through the various steps of the income calculations. 9.4.1 DFA-NL-SNAP-1, SNAP COMPUTATIONS This form must be sent with each DFA-NL-A sent for approval of SNAP benefits and to each applicant denied for income reasons. In addition, it must be sent with each DFA-NL-C and each DFA-NL-B sent for notification of an increase, decrease, or closure of SNAP benefits, when recalculations of income eligibility or benefit level are required. 9.4.2 DFA-WVW-1, WV WORKS COMPUTATIONS This form must be sent with each DFA-NL-A sent to the client for approval of WV WORKS benefits and to each applicant denied for income reasons. In addition, it must be sent with each DFA-NL-A and DFA-NL-C sent for notification of ineligibility due to income reasons. 9.4.3 DFA-NL-MN-1, AFDC-RELATED MEDICAID COMPUTATIONS This form must be sent with each DFA-NL-A sent for approval of AFDC-related Medicaid benefits. In addition, it must be sent with each DFA-NL-C and DFA-NL-B sent for changes in the spenddown amount.